Fang Shih-Yuan, Roan Jun-Neng, Lin Yu, Hsu Chih-Hsin, Chang Shih-Wei, Huang Chein-Chi, Tsai Yu-Chuan, Lam Chen-Fuh
Department of Anesthesiology, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Vasc Res. 2014;51(2):81-9. doi: 10.1159/000357619. Epub 2014 Jan 15.
The blood flow in the arteriovenous (AV) fistula is significantly reduced in diabetic patients. Statins are known to mediate pleiotropic effects in the vascular endothelium and attenuate inflammatory responses. This study tested the vascular protective effect of rosuvastatin in an experimental model of AV fistula.
One week after the induction of diabetes mellitus (DM) in rats, a fistula was created in the abdominal aorta and inferior vena cava. Rats received placebo or rosuvastatin (15 mg/kg/day) in chow for 2 weeks. The blood flow in the venous segments of the fistula was measured. The expression of proinflammatory genes and the generation of superoxide in the venous fistula were examined.
The blood flow and luminal diameter of the AV fistula was significantly enhanced in animals treated with rosuvastatin. Rosuvastatin attenuated the expression of inducible nitric oxide synthase, NADPH oxidase, and monocyte chemotactic protein-1 in the fistula. The levels of superoxide anions and proinflammatory cytokines were also suppressed in rosuvastatin-treated animals. Neointimal formation in the AV fistula was not affected following treatment with rosuvastatin.
We demonstrated that rosuvastatin improves luminal dilatation and blood flow in the AV fistula of subjects with DM. These vascular protective effects of rosuvastatin are most likely mediated by the attenuation of proinflammatory activities in the remodeled vasculature.
糖尿病患者动静脉(AV)内瘘的血流量显著降低。已知他汀类药物可介导血管内皮的多效性作用并减轻炎症反应。本研究在AV内瘘实验模型中测试了瑞舒伐他汀的血管保护作用。
大鼠诱导糖尿病(DM)1周后,在腹主动脉和下腔静脉建立内瘘。大鼠在饲料中接受安慰剂或瑞舒伐他汀(15毫克/千克/天),持续2周。测量内瘘静脉段的血流量。检测静脉内瘘中促炎基因的表达和超氧化物的生成。
接受瑞舒伐他汀治疗的动物中,AV内瘘的血流量和管腔直径显著增加。瑞舒伐他汀减弱了内瘘中诱导型一氧化氮合酶、NADPH氧化酶和单核细胞趋化蛋白-1的表达。在接受瑞舒伐他汀治疗的动物中,超氧阴离子和促炎细胞因子的水平也受到抑制。瑞舒伐他汀治疗后,AV内瘘的内膜增生未受影响。
我们证明瑞舒伐他汀可改善糖尿病患者AV内瘘的管腔扩张和血流量。瑞舒伐他汀的这些血管保护作用很可能是通过减轻重塑血管中的促炎活性来介导的。